American Journal of Obstetrics & Gynecology
Volume 200, Issue 6 , Pages 683.e1-683.e5, June 2009

Who is at risk for prolonged and postterm pregnancy?

Presented at the 75th Annual Meeting of the Pacific Coast Obstetrical and Gynecological Society, Victoria, BC, Canada, Oct. 15-19, 2008.

  • Aaron B. Caughey, MD, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, University of California, San Francisco, San Francisco, CA
    • ,
  • Naomi E. Stotland, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of California, San Francisco, San Francisco, CA
    • ,
  • A. Eugene Washington, MD, MSc

      Affiliations

    • Department of Obstetrics and Gynecology, University of California, San Francisco, San Francisco, CA
    • ,
  • Gabriel J. Escobar, MD

      Affiliations

    • Kaiser Permanente Division of Research, Perinatal Research Unit, Oakland, CA

Received 16 September 2008; received in revised form 13 December 2008; accepted 26 February 2009. published online 20 April 2009.

Objective

The objective of the study was to examine risk factors for postterm (gestational age ≥ 42 weeks) or prolonged (gestational age ≥ 41 weeks) pregnancy.

Study Design

We conducted a retrospective cohort study of all term, singleton pregnancies delivered at a mature, managed care organization. The primary outcome measures were the rates of pregnancies greater than 41 or 42 weeks' gestation. Multivariable logistic regression models were used to control for potential confounding and interaction.

Results

Specific risk factors for pregnancy beyond 41 weeks of gestation include obesity (adjusted odds ratio [aOR], 1.26; 95% confidence interval [CI], 1.16-1.37), nulliparity (aOR, 1.46; 95% CI 1.42-1.51), and maternal age 30-39 years (aOR, 1.06; 95% CI, 1.02-1.10) and 40 years or older (aOR, 1.07; 95% CI, 1.02-1.12). Additionally, African American, Latina, and Asian race/ethnicity were all associated with a lower risk of reaching 41 or 42 weeks of gestation.

Conclusion

Our findings suggest that there may be biological differences that underlie the risk for women to progress to 41 or 42 weeks of gestation. In particular, obesity is a modifiable risk factor and could potentially be prevented with prepregnancy or interpregnancy interventions.

Key words: obesity, postterm pregnancy, race/ethnicity

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 Reprints not available from the authors.

 This study was supported in part by the Agency for Healthcare Research and Quality Grant P01 HS010856 (Promoting Effective Communication and Decision Making for Diverse Populations). A.B.C. is supported by the Robert Wood Johnson Foundation as a Physician Faculty Scholar. N.E.S. is supported by the National Institute of Child Health and Human Development Grant HD01262 as a Women's Reproductive Health Research Scholar.

 The views expressed herein are those of the authors and do not necessarily represent the official views of the Agency for Healthcare Research and Quality.

 Cite this article as: Caughey AB, Stotland NE, Washington AE, et al. Who is at risk for prolonged and postterm pregnancy? Am J Obstet Gynecol 2009;200:683.e1-683.e5.

PII: S0002-9378(09)00225-7

doi:10.1016/j.ajog.2009.02.034

American Journal of Obstetrics & Gynecology
Volume 200, Issue 6 , Pages 683.e1-683.e5, June 2009

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